Introduction
Materials and methods
Vaginal examination
Statistical analysis
Results
Response rate
Baseline characteristics
Questionnaire 1, Group 1 n = 1,397 | Vaginal exam, Group 2 n = 649 | Short questionnaire non-responders, Group 3 n = 620 | ||
---|---|---|---|---|
Characteristics of the study population | No bulge | Bulge | ||
n = 570 |
n = 79 (12.2%) | |||
Mean age (range 45–84) years | 58.0 (SD ± 9.2) | 58.0 (SD ± 8.9) | 59.3 (SD ± 9.1) | 59.2 |
Mean BMI | 25.6 (SD ± 3.9) | 25.6 ± 3.7 | 25.5 ± 3.1 | |
Ethnicity
| ||||
White | 1,351 (98.4) | 545 (98.7) | 78 (100) | |
Non-white | 20 (1.5) | 7 (1.3) | 0 | |
Educational level
| (n = 1,374) | (n = 556) | (n = 78) | |
Primary only | 139 (9.9) | 63 (11.3) | 7 (9) | |
Intermediate | 1,039 (75.6) | 420 (75.5) | 60 (76.9) | |
Higher | 196 (14.3) | 73(13.1) | 11 (14.1) | |
(n = 1,340) | (n = 551) | (n = 78) | ||
Parity, median | 2 | 2 | 2 | 2 |
0 | 120 (8.9) | 46 (8.3) | 3 (3.8) | 67 (10.6) |
1 | 215 (16) | 71 (12.9) | 13 (16.6) | 102 (16.1) |
2 | 675 (50.3) | 273 (49.5) | 46 (58.9) | 277 (43.6) |
≥3 | 387 (28.8) | 161 (29.2) | 16 (20.5) | 180 (28.3) |
Menopausal status
| (n = 1,383) | (n = 557) | (n = 79) | |
(Pre)menopausal | 374 (27) | 151 (27.1) | 16 (20.2) | |
Postmenopausal | 1,009 (72.9) | 406 (72.9) | 63 (79.7) | |
(Pre)menopausal with HRT
| (n = 1,361) | (n = 551) | (n = 79) | |
(Pre)menopausal with HRT | 24 (1.7) | 9 (1.6) | 0 | |
Postmenopausal with HRT | 63 (4.6) | 23 (4.2) | 7 (8.9) | |
Smoking
| (n = 1,382) | (n = 556) | (n = 78) | |
Current smoker | 280 (20.2) | 117 (21) | 16 (20.5) | |
(n = 228) | (n = 39) | |||
Ever smoker | 345 (46.3) | 158 (54.8) | 25 (64.1) | |
Incont in pregnancy
| 342 (25.8) | 141 (30.7) | 23 (26) | |
(n = 1,328) | (n = 541) | (n = 75) | ||
POP in pregnancy
| 270 (20.3) | 113 (20.9) | 28 (37.3) | |
Surgical history
| (n = 1,384) | (n = 557) | (n = 79) | |
Prolapse | 103 (7.4) | 37 (6.6) | 16 (20.2) | |
Incontinence | 47 (3.4) | 21 (3.8) | 3 (3.9) | |
Hysterectomy | 234 (16.9) | 85 (15.3) | 20 (25.3) | |
Family history
| (n = 985) | (n = 397) | (n = 44) | |
Mother POP | 359 (26.4) | 139 (35) | 22 (50) | |
(n = 870) | (n = 357) | (n = 41) | ||
Mother UI | 258 (29.6) | 106 (29.7) | 16 (39) | |
Heavy physical work
|
n = 1,381 | (n = 553) | (n = 79) | |
Currently | 269 (19.3) | 109 (19.7) | 18 (22.8) | |
n = 1,384 | (n = 556) | (n = 79) | ||
Ever | 619 (44.3) | 248 (44.6) | 39 (49.3) |
Vaginal bulging | ||
---|---|---|
Symptomatic n = 79 | Asymptomatic n = 570 | |
Stage 0 | 15.6 (12) | 26.3 (146) |
Stage 1 | 20.8 (16) | 39 (217) |
Stage 2A | 18.1 (14) | 17.8 (99) |
Stage 2B | 16.9 (13) | 10.1 (56) |
Stage 2C | 7.8 (6) | 3.7 (6) |
Stage 3 | 16.9 (13) | 3.1 (17) |
Stage 4 | 3.9 (3) | 0 |
Distance ≥ −1, 2A | Distance ≥ 0, 2B | Distance ≥ 1, 2C | |||||||
---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | OR | 95% CI | OR | 95% CI | ||||
Vaginal bulging | 3.05 | 5.13 | 1.81 | 3.80 | 6.53 | 2.22 | 5.47 | 10.45 | 2.97 |
Age (years) | 1.04 | 1.01 | 1.06 | 1.04 | 1.01 | 1.08 | |||
BMI | 0.94 | 0.87 | 1.02 | ||||||
Nulliparous | 1.16 | 0.31 | 4.30 | ||||||
1 child | 0.44 | 0.17 | 1.17 | 0 | 0 | >1,000 | |||
2 children | 1.56 | 0.90 | 2.69 | 2.84 | 1.28 | 6.30 | 3.06 | 0.97 | 9.70 |
≥3 children | 1.54 | 0.85 | 2.78 | 2.63 | 1.13 | 6.11 | 3.33 | 1.00 | 11.00 |
Postmenopausal status | 1.29 | 0.86 | 1.94 | ||||||
Smoking current | 0.52 | 0.33 | 0.82 | 0.62 | 0.35 | 1.09 | 0.57 | 0.25 | 1.31 |
Inc surgery | 2.23 | 0.92 | 5.41 | 2.11 | 0.83 | 5.37 | |||
Educ level intermediate | 0.67 | 0.39 | 1.14 | ||||||
Heavy work current | 1.32 | 0.85 | 2.04 | 0.56 | 0.92 | 2.66 | 1.53 | 0.71 | 3.35 |
Heavy work past | 1.71 | 0.88 | 3.32 | ||||||
Pelvic girdle pain | 0.54 | 0.19 | 1.55 | ||||||
Pregn. POP | 1.40 | 0.95 | 2.07 | 1.44 | 0.89 | 2.33 | |||
Mother POP | 1.55 | 0.99 | 2.42 | 1.96 | 1.22 | 3.15 | 2.00 | 1.00 | 3.97 |
POP score | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Seeing/feeling bulge | Yes | No | ||||||||
Score | 24 | 0 | ||||||||
Age | 45–49 | 50–54 | 55–59 | 60–64 | 65–69 | 70–74 | 75–79 | 80–84 | 85 | |
Score | 0 | 3 | 6 | 9 | 13 | 16 | 19 | 22 | 25 | |
Children | 0 | 1 | 2 | ≥3 | ||||||
Score | 0 | 3 | 19 | 17 | ||||||
Smoking | Yes | No | ||||||||
Score | 0 | 8 | ||||||||
Incontinence surgery | Yes | No | ||||||||
Score | 14 | 0 | ||||||||
Current heavy work | Yes | No | ||||||||
Score | 8 | 0 | ||||||||
POP symptoms gestation | Yes | No | ||||||||
Score | 6 | 0 | ||||||||
Mother with Pop | Yes | No | ||||||||
Score | 12 | 0 | ||||||||
Prognostic index (SUM score) |